Prognostic factors of stage IV epithelial ovarian cancer: A multicenter retrospective study

Objective. In the present study, we conducted a multicenter retrospective a nalysis to elucidate the prognostic factors of stage TV epithelial ovarian cancer. Methods. In November 1999, 24 Japanese institutions received questionnaires regarding stage IV epithelial ovarian cancer patients. Eligibility criteri a included all patients with stage TV epithelial ovarian cancer who were su rgically confirmed and initially treated in each institution between Januar y 1990 and December 1997. Data were collected regarding age, performance st atus, tumor histologic subtype, site of metastasis, preoperative CA125, cyt oreductive surgery, residual disease after cytoreductive surgery, and respo nse to primary chemotherapy. Survival analysis and comparisons were perform ed by univariate and multivariate methods. Results. Two hundred twenty-five patients with stage IV ovarian cancer were identified. The median age of the patients was 54 years. The most common s ite of extraperitoneal disease was malignant pleural effusion (39.6%). Of t he 225 patients who underwent an attempt at surgical debulking, 70 (31.1%) were optimally cytoreduced. Most patients received platinum-based combinati on chemotherapy for primary chemotherapy. In multivariate analysis, perform ance status, histology, and residual disease after cytoreductive surgery we re independent prognostic predictors of outcome. The overall median surviva l for optimally debulked patients was 32 months compared to 16 months for s uboptimally debulked patients (P < 0.0001, hazard ratio: 0.415). Conclusion. Optimal surgical debulking, performance status, and histology a ppear to be important prognostic factors of survival in patients with stage IV epithelial ovarian cancer. (C) 2001 Academic Press.